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This document provides information about meningococcal disease and the vaccination requirement for students at secondary schools and colleges in Massachusetts, along with a waiver form for students

How to fill out mdph meningococcal information and

How to fill out MDPH Meningococcal Information and Waiver Form

1. Obtain the MDPH Meningococcal Information and Waiver Form from the appropriate state health department website or office.
2. Carefully read the instructions provided on the form to understand the requirements.
3. Fill out the applicant's personal information, including name, date of birth, and contact information.
4. Provide details about the applicant's vaccination history, specifically regarding meningococcal vaccines.
5. Complete the section regarding any medical conditions or allergies that may affect vaccination.
6. Sign and date the appropriate sections to confirm that the information is accurate and complete.
7. Submit the completed form as indicated in the submission instructions, either online or by mailing it to the designated agency.

Who needs MDPH Meningococcal Information and Waiver Form?

1. Individuals who are entering college or universities that require proof of meningococcal vaccination.
2. Students participating in certain programs, such as residential housing or athletic teams.
3. Parents or guardians of minors who need to waive the vaccination requirement for their children.

People Also Ask about

Is meningococcal meningitis vaccine mandatory?

At least 34 states and the District of Columbia require some type of vaccination for students who are attending college or university classes. For example: At least 22 states require meningococcal vaccine, with most requiring meningococcal vaccine for students living on campus.

What is an immunization waiver?

All states allow exemptions from school immunization requirements for children who are unable to receive vaccines for medical reasons. State laws vary regarding non-medical exemptions, for religious or personal reasons. Personal exemptions are also referred to as "philosophical exemptions" by some states.

How can I be exempt from meningitis vaccine?

Exemption is permitted with proof of immunity, non-medical exemption or birth before 1957. First-time enrollees at California State University and University of California must show proof of hepatitis B vaccine. All institutions with on-campus housing must provide information about meningococcal ACWY and B.

Why not to get the meningococcal vaccine?

There may be times when someone shouldn't get a meningococcal vaccine, like if they: Had a life-threatening allergic reaction after the vaccine. Have a life-threatening allergy to any part of the vaccine.

Is meningococcal vaccine mandatory?

Key points. CDC recommends meningococcal vaccination for all adolescents. CDC also recommends meningococcal vaccination for children and adults at increased risk for meningococcal disease. Follow the recommended immunization schedule to ensure that your patients get the meningococcal vaccines that they need.

What does it mean to waive receipt of meningococcal vaccine?

Individuals 18 years of age and older may sign a written waiver choosing not to be vaccinated against meningococcal disease after reviewing the information on the risks of meningococcal disease, the availability of the vaccine, and effectiveness of the vaccine.

Can I get the meningitis vaccine for free?

Are free or low-cost meningococcal shots available? Yes, if you don't have insurance or your insurance does not cover the cost of the meningococcal vaccines, you may be able to find free or low-cost meningococcal shots. Note that there may still be an administration fee of up to $21.22 per shot.

What happens if I don't get the meningococcal vaccine?

Meningococcal disease is a very serious infection that can cause severe scarring, loss of limbs, brain damage and death. Vaccination is a safe and effective way to protect yourself from meningococcal disease.

For pdfFiller’s FAQs

What is MDPH Meningococcal Information and Waiver Form?

The MDPH Meningococcal Information and Waiver Form is a document provided by the Massachusetts Department of Public Health that informs parents and guardians about the risks associated with meningococcal disease and allows them to waive the vaccination requirement for their child.

Who is required to file MDPH Meningococcal Information and Waiver Form?

The form is required to be filed by students who are entering the 11th grade or participating in a post-secondary education institution in Massachusetts, as they are required to either receive the meningococcal vaccination or submit a waiver.

How to fill out MDPH Meningococcal Information and Waiver Form?

To fill out the form, parents or guardians must provide their child's information, select whether the vaccination will be received or if they will waive the requirement, and sign the form to acknowledge understanding of the risks associated with meningococcal disease.

What is the purpose of MDPH Meningococcal Information and Waiver Form?

The purpose of the MDPH Meningococcal Information and Waiver Form is to provide essential information about meningococcal disease to parents and guardians, enabling them to make informed health decisions regarding vaccination for their children.

What information must be reported on MDPH Meningococcal Information and Waiver Form?

The form must report the student's name, date of birth, school name, the date of the meningococcal vaccination or the choice to waive, and the signature of the parent or guardian.